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Cholesterol - What you should know

Everybody these days knows a lot about Cholesterol. Good cholesterol, Bad Cholesterol, Lipoproteins, Triglycerides. Well It's just a little confusing. Well, It is actually very simple and you must know about it. Knowing it's importance and how you can easily keep an eye on your cholesterol level is one of the best steps you can take to prevent heart disease.

What is cholesterol?
Cholesterol is a lipid (a type of fat) which is essential for the membranes of every cell in the body, as well as playing a role in numerous other cell and body functions. It is present throughout the body, including the blood, which allows for a relatively simple blood test to determine your blood cholesterol level. As you would expect for such an important component, the body manufactures most of what it needs, about 80% of that which is present in the blood. The remainder comes from animal products.

What are lipoproteins?
Cholesterol cannot be transported by the blood around the body and delivered to the cells where it is required unless it is first packaged. The way the body does this is by combining the cholesterol with proteins call apoproteins to form a package known as a lipoprotein.

The two lipoproteins commonly referred to are low density lipoproteins (LDL) and high density lipoproteins (HDL), although there is another common form called very low density lipoproteins (VLDL). The density referred to is the amount of protein present. Therefore LDL contains a lot of cholesterol and not much protein, and HDL contains a lot of protein and not much cholesterol. So it's clear that if you want a low cholesterol level it's better to have HDL than LDL floating around.

Why is high cholesterol bad?
In the normal course of events if the level of LDL becomes too high then the liver breaks down the excess. The problem of having too much LDL is that the liver can become unable to keep up and as the LDL level rises, cholesterol begins to be deposited on the artery walls. This build up can lead to dangerous consequences as it begins to form plaques on the walls which ultimately narrow the arteries in a process known as atherosclerosis . This is how LDL got the name of "bad cholesterol".

HDL on the other hand is often referred to as "good cholesterol" and the reason behind this is that when the cholesterol is deposited on the artery walls the HDL is able to bind more cholesterol and actually reduces the buildup by taking it to the liver for breakdown.

How do I know if I have high cholesterol?
Your doctor will routinely ask you to have a cholesterol blood test. How often depends upon your medical history and health profile, but every few years is typical. The test will come back with total cholesterol level, an HDL level and other blood cholesterol levels. The level of LDL can be calculated by a simple formula ( = total cholesterol + [triglycerides/5]).

Your doctor may look at the ratio of LDL to HDL as an indication of your risk of heart disease. Thus the often quoted figures for acceptable cholesterol levels are guidelines only and all the levels are important and not just total cholesterol. However it is clear that the higher your total blood cholesterol level, the greater your risk of heart disease.

Blood Cholesterol Levels

  Desirable Borderline High High
Total Cholesterol (mg/dL) Less than 200 200-239 Above 240
LDL Cholesterol (mg/dL) Less than 130 130-159 160
HDL Cholesterol (mg/dL) More than 35    
Source: National Institutes of Health, National Heart, Lung, and Blood Institute

What Can I Do To Lower My Cholesterol?
Changing Your Eating Habits
To lower your blood cholesterol through diet, eat fewer foods high in saturated fat, total fat, and cholesterol. The total fat in your diet should average no more than 30 percent of your calories. Your fat allowance should be divided up this way:

  • Saturated fat should make up 8 to 10 percent of total calories.
  • Polyunsaturated fat should not be more than 10 percent of total calories.
  • Monounsaturated fat should make up 10 to 15 percent of total calories.

In addition, you should eat less than 300 mg of cholesterol per day. If you follow these guidelines for about 6 months and your blood cholesterol does not drop to a goal level set with you by your doctor, you may need to cut back still more on saturated fat and cholesterol.

Losing Weight
If you are overweight, losing weight also can help to lower high blood cholesterol, especially LDL cholesterol, and also may help boost HDL levels. Choose a wide variety of low-calorie, nutritious foods in moderate amounts. If you have a lot of weight to lose, ask your doctor or a nutritionist to help you develop a sensible, well-balanced plan for gradual weight loss. Avoid fad diets and diet pills, because many cause troublesome side effects and none of them works for long-term weight loss.

Getting Physical
Regular physical activity can also help you improve your cholesterol "profile." Even low- to moderate-intensity activity, if done daily, can provide benefits. Examples of such activity are pleasure walking, gardening, yardwork, moderate-to-heavy housework, dancing, and home exercise.

More vigorous exercise can raise HDL-cholesterol levels and also will improve the overall fitness of your heart. This kind of activity is called aerobic and includes jogging, swimming, jumping rope, or briskwalking or bicycling.

Regardless of the type of activity you choose, be sure to build up your activity level gradually over a period of several weeks. Also, check with your doctor first if you have any health problems, or if you are over 50 and are not used to energetic activity and plan a fairly strenuous program.

Quit smoking
Smoking cigarettes damages your blood vessel walls which makes them more vulnerable to the accumulation of cholesterol plaques. In addition smoking appears to lower your HDL levels.

If you make the changes in your diet and lifestyle described above and your LDL-cholesterol levels still remain quite high, your doctor may also suggest that you take cholesterol-lowering medications. This recommendation also will depend on whether you have any other risk factors for coronary heart disease.  If your doctor does prescribe medicines, you must also continue your cholesterol-lowering diet because the combination may allow you to take less medicine. Always try to lower your cholesterol levels with diet and other lifestyle changes before adding medication.

The Big Picture
There are relatively simple measures you can take in your everyday life to reduce the threat posed by high cholesterol. Many people find that lifestyle and diet changes can effectively reduce their cholesterol levels. However if that alone is not enough your doctor may put you on a course of cholesterol lowering medication. Understanding your cholesterol levels and how they can impact your health is an important step in allowing you to be active in reducing your risk of atherosclerosis and heart disease.

Article authored and compiled by Rajiv Anand
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